Thwaites C Louise, Yen Lam M, Nga Nguyen T N, Parry Janet, Binh Nguyen T, Loan Huynh T, Thuy Tran T D, Bethell Delia, Parry Christopher M, White Nicholas J, Day Nicholas P J, Farrar Jeremy J
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, Ho Chi Minh City, Vietnam.
Trans R Soc Trop Med Hyg. 2004 Nov;98(11):671-7. doi: 10.1016/j.trstmh.2004.01.008.
Unvaccinated individuals throughout the world are vulnerable to tetanus, but there are few data regarding the impact of focused vaccination programmes and modern intensive care facilities on the disease, particularly in the developing world. The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam admitted 2422 patients with tetanus aged > or =1 year between April 1993 and December 2002, during which time vaccine coverage and treatment facilities improved. The proportion of children < or =10 years old admitted with tetanus fell from 11.1 to 5.6% over the 10 year period (P = 0.002). The proportion of women aged 20-40 years fell from 10.1 to 1.2% (P < 0.001). Mortality rates fell from a maximum of 27.81% in 1994 to 10.04% in 2002 (P < 0.001). Thus, a marked reduction in tetanus incidence has occurred in age groups specifically targeted by the national vaccination programme. However, tetanus continues to be a major cause of morbidity and mortality in individuals outside the target population. Improved intensive care facilities, such as mechanical ventilation and low-cost infection control procedures are associated with a significant reduction in mortality.
全世界未接种疫苗的人易患破伤风，但关于针对性疫苗接种计划和现代重症监护设施对该病的影响的数据很少，尤其是在发展中世界。越南胡志明市热带病医院在1993年4月至2002年12月期间收治了2422例年龄≥1岁的破伤风患者，在此期间疫苗接种覆盖率和治疗设施有所改善。10年间，10岁及以下儿童破伤风住院比例从11.1%降至5.6%（P = 0.002）。20至40岁女性的比例从10.1%降至1.2%（P < 0.001）。死亡率从1994年最高的27.81%降至2002年的10.04%（P < 0.001）。因此，在国家疫苗接种计划专门针对的年龄组中，破伤风发病率显著下降。然而，破伤风仍然是目标人群以外个体发病和死亡的主要原因。改善的重症监护设施，如机械通气和低成本感染控制程序，与死亡率的显著降低相关。
